O presente estudo teve como objetivo investigar como que psicólogos de Orientação Psicanalítica realizam a avaliação dos Mecanismos de Defesas de crianças durante a Entrevista Lúdica Diagnóstica. Foram conduzidos dois momentos de entrevistas, sendo que o primeiro caracterizou-se por uma entrevista semiestruturada sobre a técnica de Entrevista Lúdica Diagnóstica e sobre os mecanismos de defesas com 19 psicólogas. No segundo momento, foi realizada a apresentação de um vídeo – caso clínico – de uma sessão de Entrevista Lúdica Diagnóstica para duas psicólogas, que deveriam identificar momentos de uso de mecanismos de defesa. O conteúdo das entrevistas foi analisado de acordo com a técnica de Análise de Conteúdo de Bardin (2011). Os resultados indicaram que as participantes, possuem em média 27,15 anos de formadas, sendo que 100% possuíam curso de especialização em Psicologia, 78,94% mestrado, 21% doutorado e 42,10% possuíam Formação Psicanalítica. Os autores/teóricos que embasam a atuação dessas profissionais mais citados foram: Melanie Klein, Donald W. Winnicott, Arminda Aberastury, Sigmund Freud, Antonino Ferro e Wilfred Bion. A análise de conteúdo das falas das entrevistadas apontou para sete categorias, a saber, “Influência do Tripé Psicanalítico na Avaliação dos Mecanismos de Defesa”, “Expressão e Identificação dos Mecanismos de Defesa na Prática Clínica”, “Uso da Entrevista Lúdica Diagnóstica para Avaliar os Mecanismos de Defesa”, “Dificuldades de Explicar o Modo de Avaliação dos Mecanismos de Defesa”, “Forma Como os Pacientes Lidam com os Mecanismos de Defesa”, “Adequação dos Mecanismos de Defesa à Faixa Etária e Sexo” e “Materiais Utilizados na Avaliação dos Mecanismos de Defesa”. Algumas refletem a dificuldade das participantes em expressar de forma didática o surgimento dos mecanismos de defesas na entrevista com crianças ou, até mesmo, de saber identificar os mecanismos de defesas que são fundamentais para estabelecer o funcionamento de crianças durante as sessões. Outras ressaltam a importância de conhecer profundamente as etapas do desenvolvimento infantil para poder identificar e analisar a pertinência dos mecanismos de defesas que se fizeram presentes. Os achados nessa pesquisa vão ao encontro da teoria de autores clássicos e contemporâneos, no entanto, a escassez de estudos ficou evidente, ainda mais quando relacionado com a importância dos mecanismos de defesas na vida infantil e sua expressão no brincar durante a Entrevista Lúdica Diagnóstica. / The present study aimed to investigate how Psychoanalytic psychologists investigate the mechanisms Defenses in children during a Diagnostic interview. We conducted two stages of interviews, the first of which was characterized by a interview about the technique of Diagnostic interview and the mechanisms defense with 19 psychologists. In the second, there was the presentation of a tape - case study - a session Diagnostic interview for two psychologists, who should identify times of use of defense mechanisms. The content of the interviews was analyzed according to the technique of content analysis of Bardin (2011). The results indicated that the participants have an average of 27.15 years of formed, and 100 % had specialization course in Psychology, 78.94 % master's degree, 21 % doctorate and 42.10 % had Psychoanalytic Training. The authors / theorists that support the work of these professionals most frequently cited were: Melanie Klein, Donald W. Winnicott, Arminda Aberastury, Sigmund Freud, Antonino Ferro and Wilfred Bion. The content analysis of the interviews carried out pointed to seven categories , namely , "Influence of the Psychoanalytic Tripod rating Defense Mechanisms" , "Expression and Identification of the Mechanisms of Defense Clinical Practice", "Use of Diagnostic Interview for Assessing Ludic Mechanisms of Defense", "Difficulties in Explaining Mode Evaluation of Defense Mechanisms", "Shape How Patients Cope with the Defense Mechanisms", "Adaptation of Defense Mechanisms for Age Group and Gender" and "Materials Used in assessment of Defense Mechanisms". Some of the participants reflect the difficulty in expressing didactically the emergence of defense mechanisms in the interview with children or even to know identify defense mechanisms that are fundamental to establish the functioning of children during the sessions. Others emphasize the importance of knowing deeply the stages of child development in order to identify and examine the relevance of defense mechanisms that were present. The findings in this research are in the theory of classical and contemporary authors, however, the scarcity of studies was evident, especially when considering the importance of defense mechanisms in early life and its expression in play during Diagnostic Interview.

O presente estudo teve como objetivo investigar como que psicólogos de Orientação Psicanalítica realizam a avaliação dos Mecanismos de Defesas de crianças durante a Entrevista Lúdica Diagnóstica. Foram conduzidos dois momentos de entrevistas, sendo que o primeiro caracterizou-se por uma entrevista semiestruturada sobre a técnica de Entrevista Lúdica Diagnóstica e sobre os mecanismos de defesas com 19 psicólogas. No segundo momento, foi realizada a apresentação de um vídeo – caso clínico – de uma sessão de Entrevista Lúdica Diagnóstica para duas psicólogas, que deveriam identificar momentos de uso de mecanismos de defesa. O conteúdo das entrevistas foi analisado de acordo com a técnica de Análise de Conteúdo de Bardin (2011). Os resultados indicaram que as participantes, possuem em média 27,15 anos de formadas, sendo que 100% possuíam curso de especialização em Psicologia, 78,94% mestrado, 21% doutorado e 42,10% possuíam Formação Psicanalítica. Os autores/teóricos que embasam a atuação dessas profissionais mais citados foram: Melanie Klein, Donald W. Winnicott, Arminda Aberastury, Sigmund Freud, Antonino Ferro e Wilfred Bion. A análise de conteúdo das falas das entrevistadas apontou para sete categorias, a saber, “Influência do Tripé Psicanalítico na Avaliação dos Mecanismos de Defesa”, “Expressão e Identificação dos Mecanismos de Defesa na Prática Clínica”, “Uso da Entrevista Lúdica Diagnóstica para Avaliar os Mecanismos de Defesa”, “Dificuldades de Explicar o Modo de Avaliação dos Mecanismos de Defesa”, “Forma Como os Pacientes Lidam com os Mecanismos de Defesa”, “Adequação dos Mecanismos de Defesa à Faixa Etária e Sexo” e “Materiais Utilizados na Avaliação dos Mecanismos de Defesa”. Algumas refletem a dificuldade das participantes em expressar de forma didática o surgimento dos mecanismos de defesas na entrevista com crianças ou, até mesmo, de saber identificar os mecanismos de defesas que são fundamentais para estabelecer o funcionamento de crianças durante as sessões. Outras ressaltam a importância de conhecer profundamente as etapas do desenvolvimento infantil para poder identificar e analisar a pertinência dos mecanismos de defesas que se fizeram presentes. Os achados nessa pesquisa vão ao encontro da teoria de autores clássicos e contemporâneos, no entanto, a escassez de estudos ficou evidente, ainda mais quando relacionado com a importância dos mecanismos de defesas na vida infantil e sua expressão no brincar durante a Entrevista Lúdica Diagnóstica. / The present study aimed to investigate how Psychoanalytic psychologists investigate the mechanisms Defenses in children during a Diagnostic interview. We conducted two stages of interviews, the first of which was characterized by a interview about the technique of Diagnostic interview and the mechanisms defense with 19 psychologists. In the second, there was the presentation of a tape - case study - a session Diagnostic interview for two psychologists, who should identify times of use of defense mechanisms. The content of the interviews was analyzed according to the technique of content analysis of Bardin (2011). The results indicated that the participants have an average of 27.15 years of formed, and 100 % had specialization course in Psychology, 78.94 % master's degree, 21 % doctorate and 42.10 % had Psychoanalytic Training. The authors / theorists that support the work of these professionals most frequently cited were: Melanie Klein, Donald W. Winnicott, Arminda Aberastury, Sigmund Freud, Antonino Ferro and Wilfred Bion. The content analysis of the interviews carried out pointed to seven categories , namely , "Influence of the Psychoanalytic Tripod rating Defense Mechanisms" , "Expression and Identification of the Mechanisms of Defense Clinical Practice", "Use of Diagnostic Interview for Assessing Ludic Mechanisms of Defense", "Difficulties in Explaining Mode Evaluation of Defense Mechanisms", "Shape How Patients Cope with the Defense Mechanisms", "Adaptation of Defense Mechanisms for Age Group and Gender" and "Materials Used in assessment of Defense Mechanisms". Some of the participants reflect the difficulty in expressing didactically the emergence of defense mechanisms in the interview with children or even to know identify defense mechanisms that are fundamental to establish the functioning of children during the sessions. Others emphasize the importance of knowing deeply the stages of child development in order to identify and examine the relevance of defense mechanisms that were present. The findings in this research are in the theory of classical and contemporary authors, however, the scarcity of studies was evident, especially when considering the importance of defense mechanisms in early life and its expression in play during Diagnostic Interview.

The World Health Organization-Composite International Diagnostic Interview (WHO-CIDI) is a highly structured interview for the assessment of mental disorders, based on the definitions and criteria of the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Over the past decade it has become evident that the CIDI does not sufficiently address the assessment needs of women. Women are affected by most mental disorders, particularly mood and anxiety disorders, approximately twice as frequently as men. Women-specific disorders, such as Premenstrual Syndrome (PMS), Premenstrual Dysphoric Disorder (PMDD), psychiatric disorders during pregnancy and postpartum as well as during the perimenopause, menopause and beyond are not addressed by the standard CIDI diagnostic modules. In addition, the CIDI in its current form does not address the potential effect that female reproductive milestones may have on diagnosis, treatment and prevention of mental disorders in women. Our aim was to develop a new women specific platform (CIDI-VENUS; CIDI-V) to be embedded in the existing CIDI that will address the above mentioned current deficiencies. Guided by a team of experts in the field of Women’s Mental Health from Canada and Germany the following modules were developed: 1) A complete menstrual history and comprehensive contraceptive history with a link to the Premenstrual Symptoms Screening Tool (PSST). 2) A complete perinatal history of pregnancies, miscarriages, terminations, still births, death of a child, with details of current pregnancy including gestation and expected date of confinement, labour history and breastfeeding, history of tobacco, alcohol, and other substance use including prescription drugs during pregnancy and postpartum, a section on specific phobias and on recurrent obsessive/compulsive thoughts/behaviours (OCD) related to the baby with a link to the Perinatal Obsessive-Compulsive Scale (POCS), as well as a link to the Edinburgh Postnatal Depression Scale (EPDS). 3). A detailed history of use of hormone therapy (e.g. pills, patches, implants, etc.) with a focus on (peri-) menopausal women, differentiating between physical and psychological symptoms with a link to the Menopause Visual Analogue Scales (M-VAS) and to the Greene Climacteric Scale. 4) An iterative module concluding each CIDI section to specify the course of mental disorders during the reproductive stages and menopausal transition. While retaining core diagnostic sections and diagnostic algorithms, the CIDI-V is enriched by women-specific diagnostic modules, providing a wealth of clinically relevant information about women’s mental health, not available anywhere else in our current psychiatric diagnostic instruments.

Background: A initial interview with addicted people is described as a mapping of the patient's risk behavior in relation to the use of addictive substances. It also includes an assessment of the overall condition of the patient and subsequent determination of the therapeutic plan. It is a complex examination that which takes time for 60 minutes. The question is what should we do in this interview. How to make a plan for treatment with the patient. Objective: The aim of this thesis is to propose the structure of an aditological examination for the outpatient treatment center named Adiktologicka ambulance. The next step is to do the verification of the interview in practice. Methods: On the basis of professional literature, we formulate the possible contents of the "adictological input" exercise. We are interested not only in what to do but also how. We work in a psychodynamic context. Subsequently, we propose initial interview for addected people in the outpatient treatment center for addiction. We highlight the importance of the institutional context. The interview must match the focus and tasks of the certain institution. Finally, we briefly present the experience of the worker with addicted people. Discussions and Conclusions: We found out that an initial examination took more than one hour....

New Spanish versions of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Personality Assessment Inventory (PAI) were assessed with the Spanish translation of the Diagnostic Interview Schedule (DIS) as the gold standard. Findings from categorical and dimensional analyses suggest that, although the degree of diagnostic concordance of both measures with the DIS was found to be moderately high, the MMPI-2 clinical scales yielded greater specificity but lower sensitivity than the PAI scales on two of four diagnostic categories (i.e., Major Depression, and Schizophrenia). Both measures failed to correctly diagnose Anxiety Disorders, while the MMPI-2 also showed poor diagnostic accuracy with Alcohol Dependence.

The World Health Organization-Composite International Diagnostic Interview (WHO-CIDI) is a highly structured interview for the assessment of mental disorders, based on the definitions and criteria of the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Over the past decade it has become evident that the CIDI does not sufficiently address the assessment needs of women. Women are affected by most mental disorders, particularly mood and anxiety disorders, approximately twice as frequently as men. Women-specific disorders, such as Premenstrual Syndrome (PMS), Premenstrual Dysphoric Disorder (PMDD), psychiatric disorders during pregnancy and postpartum as well as during the perimenopause, menopause and beyond are not addressed by the standard CIDI diagnostic modules. In addition, the CIDI in its current form does not address the potential effect that female reproductive milestones may have on diagnosis, treatment and prevention of mental disorders in women. Our aim was to develop a new women specific platform (CIDI-VENUS; CIDI-V) to be embedded in the existing CIDI that will address the above mentioned current deficiencies. Guided by a team of experts in the field of Women’s Mental Health from Canada and Germany the following modules were developed: 1) A complete menstrual history and comprehensive contraceptive history with a link to the Premenstrual Symptoms Screening Tool (PSST). 2) A complete perinatal history of pregnancies, miscarriages, terminations, still births, death of a child, with details of current pregnancy including gestation and expected date of confinement, labour history and breastfeeding, history of tobacco, alcohol, and other substance use including prescription drugs during pregnancy and postpartum, a section on specific phobias and on recurrent obsessive/compulsive thoughts/behaviours (OCD) related to the baby with a link to the Perinatal Obsessive-Compulsive Scale (POCS), as well as a link to the Edinburgh Postnatal Depression Scale (EPDS). 3). A detailed history of use of hormone therapy (e.g. pills, patches, implants, etc.) with a focus on (peri-) menopausal women, differentiating between physical and psychological symptoms with a link to the Menopause Visual Analogue Scales (M-VAS) and to the Greene Climacteric Scale. 4) An iterative module concluding each CIDI section to specify the course of mental disorders during the reproductive stages and menopausal transition. While retaining core diagnostic sections and diagnostic algorithms, the CIDI-V is enriched by women-specific diagnostic modules, providing a wealth of clinically relevant information about women’s mental health, not available anywhere else in our current psychiatric diagnostic instruments.

Les facteurs psychosociaux au travail sont devenus un enjeu de santé publique et de santé au travail et font l’objet d’une attention particulière des politiques de prévention. Cependant, le rôle étiologique de ces facteurs sur la santé mentale reste à approfondir, notamment via des études intégrant un outil diagnostique, rarement utilisé dans ce contexte. De plus, le rôle de ces facteurs dans l’explication des inégalités sociales de santé mentale reste mal connu. Les objectifs de la thèse sont donc l’étude du rôle étiologique des facteurs psychosociaux au travail sur les troubles de la santé mentale mesurés par un instrument diagnostique et l’évaluation de leur contribution dans les inégalités sociales de santé mentale.Deux jeux de données ont été exploités : Samotrace (enquête régionale sur 6056 salariés) et SIP -Santé et Itinéraire Professionnel- (enquête nationale sur 7709 travailleurs). Samotrace se caractérise par la présence de questionnaires validés pour la mesure des facteurs psychosociaux au travail, et SIP par la présence d’un outil diagnostique pour la mesure de la dépression et de l’anxiété. Des méthodes statistiques multivariées ont été employées, notamment la régression logistique. Des tests d’interactions et la méthode du bootstrap ont également été utilisés. Toutes les analyses ont été réalisées séparément pour les hommes et les femmes.La faible latitude décisionnelle, le surinvestissement et les exigences émotionnelles étaient des facteurs de risque de dépression et d’anxiété, pour les deux genres. D’autres facteurs de risque spécifiques ont été observés selon la pathologie et le genre (insécurité de l’emploi, forte demande psychologique, conflit éthique, faibles récompenses). Peu d’inégalités sociales de santé mentale ont été mises en évidence hormis pour la santé perçue, au détriment des salariés les moins qualifiés. Les facteurs professionnels contribuaient à réduire les inégalités sociales de santé perçue de 76% et plus, selon le genre et la profession. Parmi eux, les facteurs psychosociaux au travail jouaient un rôle substantiel notamment la faible latitude décisionnelle, et dans une moindre mesure (selon la profession et le genre) : le faible soutien social, les faibles récompenses, le travail de nuit, les difficultés de conciliation vie professionnelle-vie familiale, les violences et menaces/humiliations.Des actions de prévention ciblées sur les facteurs de risque identifiés, y compris sur des facteurs psychosociaux au travail émergents, pourraient être envisagées et une meilleure prise en compte de ces facteurs en milieu de travail serait nécessaire. Développer les connaissances sous l’angle des inégalités sociales de santé mentale permettrait de dégager des pistes d’actions correctives adaptées aux groupes sociaux ou professionnels les plus concernés. Les études étant transversales, les résultats observés devront être confirmés par d’autres travaux. / Psychosocial work factors are a public health and occupational health issue and are the object of special prevention policies. However, the etiological role of these factors on mental health need to be developed, particularly studies using diagnostic interviews, rarely used in this context. Moreover, the role of these factors in the explanation of social inequalities in mental health is still unknown. The objectives of this PhD thesis are to study the etiological role of psychosocial work factors on mental disorders, measured using a diagnostic interview, and to evaluate the contribution of these factors to social inequalities in mental health.The data from two surveys were used: Samotrace (regional survey based on 6056 employees) and SIP (national survey based on 7709 workers). The main feature for Samotrace was the use of validated questionnaires to measure psychosocial work factors, and for SIP it was the use of a diagnostic instrument to measure depressive and anxiety disorders. Multivariate analyses were conducted, including logistic regression analysis. Interaction tests and the bootstrap method were also used. All analyses were carried out separately for men and women.Low decision latitude, overcommitment and emotional demands were found to be risk factors for depressive and anxiety disorders, for both genders. Other risk factors were observed according to gender or mental health outcome studied (job insecurity, high psychological demands, ethical conflict, low reward). Few social inequalities in mental health were observed except for self-reported health; manual workers being more likely to report poor health. Occupational factors reduced social inequalities in health by 76% and more, according to gender and occupation studied. Among occupational factors, psychosocial work factors played a substantial role, particularly low decision latitude, and to a lesser extent (according to occupation and gender): low social support, low reward, night work, work-life imbalance, physical violence and bullying.Prevention actions focussing on identified risk factors, including emergent psychosocial work factors, should be considered and a better implementation at workplace would be necessary. Improving knowledge on social inequalities of mental health may lead to adequate preventive actions targeting the most exposed social or occupational groups. As our studies were cross-sectional, our results should be confirmed by forthcoming prospective studies.

Background Lack of coordination between screening studies for common mental disorders in primary care and community epidemiological samples impedes progress in clinical epidemiology. Short screening scales based on the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI), the diagnostic interview used in community epidemiological surveys throughout the world, were developed to address this problem. Method Expert reviews and cognitive interviews generated CIDI screening scale (CIDI-SC) item pools for 30-day DSM-IV-TR major depressive episode (MDE), generalized anxiety disorder (GAD), panic disorder (PD) and bipolar disorder (BPD). These items were administered to 3058 unselected patients in 29 US primary care offices. Blinded SCID clinical reinterviews were administered to 206 of these patients, oversampling screened positives. Results Stepwise regression selected optimal screening items to predict clinical diagnoses. Excellent concordance [area under the receiver operating characteristic curve (AUC)] was found between continuous CIDI-SC and DSM-IV/SCID diagnoses of 30-day MDE (0.93), GAD (0.88), PD (0.90) and BPD (0.97), with only 9–38 questions needed to administer all scales. CIDI-SC versus SCID prevalence differences are insignificant at the optimal CIDI-SC diagnostic thresholds (χ2 1 = 0.0–2.9, p = 0.09–0.94). Individual-level diagnostic concordance at these thresholds is substantial (AUC 0.81–0.86, sensitivity 68.0–80.2%, specificity 90.1–98.8%). Likelihood ratio positive (LR+) exceeds 10 and LR− is 0.1 or less at informative thresholds for all diagnoses. Conclusions CIDI-SC operating characteristics are equivalent (MDE, GAD) or superior (PD, BPD) to those of the best alternative screening scales. CIDI-SC results can be compared directly to general population CIDI survey results or used to target and streamline second-stage CIDIs.

The measurement of reliable and valid indicators of early child development is necessary for assessing phenomena and is useful in the monitoring of ongoing efforts to eradicate inequalities in the social determinants of health. There is an increasing awareness of the contextual, cultural, and developmental influences on constructs used in early child development (ECD) research. Using a measurement perspective, this dissertation examined the issue of measurement invariance and psychometric validity in early child development research. A construct violates the principle of invariance when two persons from different populations who are theoretically identical on the construct being measured have different scores on it. This dissertation consists of three journal-style manuscripts (published or under review) that were used as examples to address the importance of the issue of measurement invariance and psychometric validity in ECD research using data from two unique areas: autism and executive functioning. The three data sets were collected on pre-school children with parents and or teachers as informants and were chosen to represent different levels of data collection – clinical, community, and population. These data sets allowed for the examination of measurement invariance by type of informant, sex, and age of child. The results from the three studies illustrate the importance of assessing measurement invariance in ECD and whether or not the instruments examined can be used to assess sub-group differences with confidence. A lack of measurement invariance found for two of the studies, suggests that observed group differences in latent constructs could be attributed, in part, to measurement bias. More importantly, bias in the measurement of the constructs of severity of social impairment symptoms in autism, and executive functioning across groups could have an impact on services such as patient treatment. These biases could also influence public policy development, particularly when there may be an underlying need for a cross-group approach where belief systems may affect the meaning and structure of constructs. In summary, measurement invariance should be a prerequisite for making any meaningful comparisons across groups. A requirement of establishing measurement invariance should be included in the guidelines for comparative research studies as a necessary first step before an instrument is adopted for use.

The measurement of reliable and valid indicators of early child development is necessary for assessing phenomena and is useful in the monitoring of ongoing efforts to eradicate inequalities in the social determinants of health. There is an increasing awareness of the contextual, cultural, and developmental influences on constructs used in early child development (ECD) research. Using a measurement perspective, this dissertation examined the issue of measurement invariance and psychometric validity in early child development research. A construct violates the principle of invariance when two persons from different populations who are theoretically identical on the construct being measured have different scores on it. This dissertation consists of three journal-style manuscripts (published or under review) that were used as examples to address the importance of the issue of measurement invariance and psychometric validity in ECD research using data from two unique areas: autism and executive functioning. The three data sets were collected on pre-school children with parents and or teachers as informants and were chosen to represent different levels of data collection – clinical, community, and population. These data sets allowed for the examination of measurement invariance by type of informant, sex, and age of child. The results from the three studies illustrate the importance of assessing measurement invariance in ECD and whether or not the instruments examined can be used to assess sub-group differences with confidence. A lack of measurement invariance found for two of the studies, suggests that observed group differences in latent constructs could be attributed, in part, to measurement bias. More importantly, bias in the measurement of the constructs of severity of social impairment symptoms in autism, and executive functioning across groups could have an impact on services such as patient treatment. These biases could also influence public policy development, particularly when there may be an underlying need for a cross-group approach where belief systems may affect the meaning and structure of constructs. In summary, measurement invariance should be a prerequisite for making any meaningful comparisons across groups. A requirement of establishing measurement invariance should be included in the guidelines for comparative research studies as a necessary first step before an instrument is adopted for use.